Publication

Prevention of rupture of abdominal aortic aneurysm

Journal Paper/Review - Jan 1, 2010

Units
PubMed

Citation
Savolainen H, Novak J, Dick F, Widmer M, Carrel T, Schmidli J, Meier B. Prevention of rupture of abdominal aortic aneurysm. Scand J Surg 2010; 99:217-20.
Type
Journal Paper/Review (English)
Journal
Scand J Surg 2010; 99
Publication Date
Jan 1, 2010
Issn Print
1457-4969
Pages
217-20
Brief description/objective

BACKGROUND AND AIMS
Two thirds of patients with an abdominal aortic aneurysm (AAA) have relevant coronary artery disease (CAD). AAAs are prevalent in up to 16% of smokers with CAD. General screening of AAA is controversial. Aim was to assess the potential of finding AAA prior to rupture among patients with known CAD. Main endpoint was whether AAA could have been found during follow-up by sonography or at other time of cardiovascular evaluation.

MATERIAL AND METHODS
Retrospective study. 213 consecutive, formerly unknown emergently operated AAAs, treated emergently for symptoms (n = 91) or rupture (n = 122) (rAAA) between January 1998 and June 2005. Patient charts were analysed and primary care physicians contacted.

RESULTS
At presentation, mean age was 71 (+/-9) years, twenty (9%) were female. AAA had a mean diameter of 7.6 cm. Two thirds (143) were clinically obese (BMI 27 +/-5). 137 (64%) were active smokers, 32 (15%) had diabetes, 151 (71%) were hypertensive, and 80 (38%) received statin treatment. CAD had been diagnosed in 95 (45%) 9 years earlier and followed up. Thirty-five (16%) had had myocardial infarction. Echocardiography had been performed in 52 (24%). Thirty day mortality after open surgery was 25 (21%).

CONCLUSION
All patients with rAAA had been seen by a GP or cardiologist within a year prior to presentation. The cost effectiveness of selective AAA screening should be evaluated in a larger study.